French Public Health Code
In forceThe Director General of the Mayotte Regional Health Agency sets the fees for services provided by public health establishments by order. These rates are used as the basis for :
1° Invoicing for patient care and accommodation ;
2° The exercise of recourse against third parties that the social security fund implements under the conditions set out in articles L. 376-1 and L. 454-1 of the Social Security Code.
In application of 1° above, the costs of hospitalisation, consultations and outpatient treatment are paid directly by persons who are not affiliated to the Mayotte sickness, maternity, invalidity and death insurance scheme.
However, these costs are partially or fully covered:
a) By the State for persons for whom the lack of care may lead to a serious and lasting deterioration in their state of health and for those receiving care as part of the fight against serious transmissible diseases when this care is provided by public health establishments; the resources of these persons must be less than an amount set by a decision of the State representative;
b) By the social security fund, for persons who are affiliated to a sickness and maternity insurance scheme in mainland France or the overseas departments or their dependants, under the conditions set by the decree coordinating the social security schemes provided for in article 25 of order no. 2002-411 of 27 March 2002 relating to health and social protection in Mayotte.
Expenses relating to minors and those intended to protect the health of an unborn child are fully covered when the resources of the persons concerned are less than the amount mentioned in the sixth paragraph.
Persons who are not affiliated to the Mayotte health insurance scheme or to a health insurance scheme in mainland France or the overseas departments are required, in order to receive care from public health establishments, to deposit a financial provision, the amount of which, adapted to the category of care requested, is defined, within the maximum limit of the corresponding tariff, by order of the director of the Mayotte regional health agency. The persons mentioned in a and in the eighth paragraph above are exempt from depositing this provision.
